Background/Purpose: Patient satisfaction, both with the process of care and the outcome of care, is critical for measuring the quality and value of elective procedures such as arthroplasty, leading the Centers for Medicare and Medicaid (CMS) to include patient satisfaction with the process of care in their payment models. The purpose of this study was to evaluate the association between patient-reported early postoperative satisfaction with the process of care and 2-year satisfaction with the outcome of care after primary total hip (THA) and total knee arthroplasty (TKA).

Methods: We identified patients that underwent primary THA or TKA from an institutional arthroplasty registry which administered a survey measuring satisfaction with the outcome of care to patients 2-years post-operatively. An overall satisfaction score was calculated using a previously validated score. Patient satisfaction with the process of care, as measured by the Press Ganey (PG) inpatient survey administered to patients shortly after discharge, was obtained and linked to the registry data. Both satisfaction measures have a range of 0-100, with higher scores indicating greater satisfaction. Spearman rank correlation coefficients were calculated to evaluate the association between satisfaction with the process of care (PG score) and the outcome of care (2-year score).

Results: The cohort included 721 TKA patients and 760 THA patients who underwent surgery at our institution and completed both the PG survey and 2-year satisfaction questionnaire (Table 1). The mean age was 65.1 years, mean BMI was 28.8, and 56% were female. Satisfaction was high for both measures, with a mean PG score of 88.2 and a mean 2-year score of 95.6. Correlation between the two measures was fair to poor, with Spearman rank correlation coefficients of 0.23 for TKA patients (p < 0.001) and 0.13 for THA patients (p < 0.001). Bubble charts showing the distribution of patients by PG score and 2-year score for TKA and THA are presented in Figures 1a and 1b, respectively.

Conclusion: We found weak correlation between measurements of satisfaction with the process of care surrounding joint arthroplasty using the PG survey and satisfaction with the outcome of care after hip and knee arthroplasty using a validated 2-year satisfaction score. Policymakers should consider both facets of patient satisfaction when considering hospital performance and the value of elective surgical procedures.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/satisfaction-with-the-process-versus-outcome-of-care-in-total-hip-and-knee-arthroplasty/